India-Bangladesh: Trafficking and abuse of pharmaceuticals - an issue of growing public concern

UNODC recently interviewed Mr. M.K. Pal, Deputy Drugs Controller and Controlling Authority of the Indian State of Tripura, who participated in a seminar on strengthening the response to the abuse of pharmaceuticals. The seminar, which was organized jointly by UNODC and the Government of India, was held in New Delhi and attended by officials from the northern and eastern States of India and other law enforcement officers. At the seminar, participants tried to identify legal, regulatory and enforcement gaps in addressing the abuse of pharmaceuticals.

UNODC: What are some of the main pharmaceuticals of abuse in Tripura?

Mr. Pal: Codeine phosphate, which is contained in cough preparations, is the main drug that is abused in the State of Tripura. Codeine is a narcotic drug and causes addiction when used in large quantities over a period of time. One cough preparation contains chlorphenirmine maleate, an anti-histaminic, in addition to codeine phosphate, which causes sedation. Empty bottles of codeine phosphate cough syrups of different brands are often found in public and touristy places. In addition to the above, pharmaceuticals like buprenorphine, alprazolam, diazepam, nitrazepam, cyproheptadine, dexamethazone and spasmoproxivon capsules are misused in Tripura.

UNODC: How serious is the problem of pharmaceutical abuse in Tripura?

Mr. Pal: The problem is serious, because pharmaceuticals are more affordable and easily available at retail outlets. They are often used as substitutes by drug users. The problem gets magnified when drug users begin to take them over a long period of time. Distributors, wholesalers or retailers do not bring cough syrups legally into Tripura but smuggle them in trucks into the State under a fictitious name. While large quantities go undetected, only a fraction is caught either by the police or by the Customs Department. Initially, the drug used to be procured by authorized stockists, but later the licenses of all the stockists in Tripura were cancelled due to non-maintenance of proper sales record as per the Drugs and Cosmetics Rules of 1945. In spite of this, the drug still continues to enter the State through illegal channels and is mostly smuggled to Bangladesh. T here are no legal or illegal manufacturers of the product within the State. The illegal import of the drug has created a law-and-order as well as a socio-economic problem.

UNODC: How is Phensedyl smuggled into Bangladesh and why mainly into Bangladesh?

Mr. Pal: Phensedyl and other cough syrups are illegally brought into the State with forged documents and at times are hidden under other commodities like in trucks and buses. Once inside, they find their way to Bangladesh, with which Tripura shares two thirds of its border. The drug is generally sent in its original packaging. Since liquor is banned in Bangladesh, the drug became a popular alternative for alcohol. Phensedyl used to contain codeine phosphate along with hydrochloride ephedrine and promethazine, a unique combination for addiction. This is what made it a popular drug of abuse and unfortunately the trend still continues even after the chemical formulation was changed.

UNODC: What is the Government of Tripura doing to address this problem?

Mr. Pal: One of the major challenges lies in the implementation of the Drugs and Cosmetics Rules of 1945 by States. Due to a lack of supervision or verification by States, huge quantities of cough syrup find their way to Tripura in an unauthorized manner. While the State Drug Control of Tripura is trying its best to address the problem, it is unable to contain it because of inadequacies in manpower and infrastructure. The State Government has taken steps to address this issue and is sensitizing the members of the Chemists and Druggists Association, as well as the public in general, about this growing concern. Also the manufacturers of such products do not verify whether their products are sold legally i.e. against prescriptions of registered medical practitioners. Unless State drugs controllers, manufacturers and drug dealers coordinate and cooperate jointly, it would be very difficult to contain the misuse of such products. The State Government is also exploring the possibility of restricting the entry for such products into the State by modifying the rules concerning narcotic drugs of Tripura.

The seminar on strengthening the response to the abuse of pharmaceuticals in India was organized under the UNODC regional project on
'strengthening drug law enforcement capabilities'. This project is possible thanks to the contribution of the Government of India.